Roccaforte Vincenzo, Sabbatini Giovanni, Panella Rossella, Daves Massimo, Formenti Paolo, Gotti Miriam, Galimberti Andrea, Spreafico Marta, Piccin Andrea, Lippi Giuseppe, Pezzi Angelo, Pastori Stefano
S.C. Analisi Chimico Cliniche e Microbiologiche, 159114 ASST Nord Milano , Ospedale Bassini, Cinisello Balsamo, Italy.
S.C. Anestesia, Rianimazione e Terapia Intensiva, 159114 ASST Nord Milano , Ospedale Bassini, Cinisello Balsamo, Italy.
Clin Chem Lab Med. 2025 Jan 27;63(5):1031-1042. doi: 10.1515/cclm-2024-1202. Print 2025 Apr 28.
The aim of the study was to evaluate the predictive value of cell population data (CPD) parameters in comparison with procalcitonin (PCT) and C-reactive protein (CRP) for an early diagnosis of sepsis in intensive care unit (ICU). The effect of renal function on CPD, PCT and CRP, in septic and non-septic patients was also investigated.
This is a retrospective, observational and single-center study, performed with data collected from patients consecutively admitted to the ICU of the Edoardo Bassini Hospital in Milan. Patients were divided in septic and non-septic according to Sepsis-III criteria. The control group was formed by critically ill patients without sepsis. Patients with sepsis were further divided in patients with sepsis and patients with septic shock.
A significant difference between septic and non-septic patients was found for neutrophils complexity (NE-SSC), neutrophils fluorescence intensity (NE-SFL), width of dispersion of neutrophils fluorescence (NE-WY), monocytes complexity (MO-X), monocytes fluorescence intensity (MO-Y), PCT and CRP parameters. PCT, neutrophils sixe (NE-FSC), NE-WY, width of dispersion of neutrophils size (NE-WZ) and MO-X discriminated sepsis and septic-shock patients. CPD parameters were not influenced by renal function. CPD, PCT and CRP had a heterogeneous diagnostic performance efficiency in the prediction of sepsis. Overall, NE-SSC, NE-SFL, width of dispersion of neutrophils complexity (NE-WX), MO-X, MO-Y, PCT and CRP displayed the best diagnostic performance for sepsis.
This study suggested that some CPD parameters (i.e., NE-SFL and MO-X) might provide useful information for diagnosis and management of sepsis.
本研究旨在评估细胞群体数据（CPD）参数与降钙素原（PCT）和C反应蛋白（CRP）相比，对重症监护病房（ICU）中脓毒症早期诊断的预测价值。同时还研究了肾功能对脓毒症和非脓毒症患者CPD、PCT和CRP的影响。
这是一项回顾性、观察性单中心研究，数据来自米兰埃多阿尔多·巴斯西尼医院ICU连续收治的患者。根据脓毒症-III标准将患者分为脓毒症组和非脓毒症组。对照组由无脓毒症的危重症患者组成。脓毒症患者进一步分为脓毒症患者和脓毒性休克患者。
脓毒症患者和非脓毒症患者在中性粒细胞复杂性（NE-SSC）、中性粒细胞荧光强度（NE-SFL）、中性粒细胞荧光弥散宽度（NE-WY）、单核细胞复杂性（MO-X）、单核细胞荧光强度（MO-Y）、PCT和CRP参数方面存在显著差异。PCT、中性粒细胞大小（NE-FSC）、NE-WY、中性粒细胞大小弥散宽度（NE-WZ）和MO-X可区分脓毒症和脓毒性休克患者。CPD参数不受肾功能影响。CPD、PCT和CRP在脓毒症预测中的诊断性能效率存在异质性。总体而言，NE-SSC、NE-SFL、中性粒细胞复杂性弥散宽度（NE-WX）、MO-X、MO-Y、PCT和CRP对脓毒症的诊断性能最佳。
本研究表明，一些CPD参数（即NE-SFL和MO-X）可能为脓毒症的诊断和管理提供有用信息。
